Your safety and optimal oral health are our priorities. The following information enables us to provide you with the best oral health care services safely and effectively. Please complete the entire form. During you visit you will be asked questions regarding your questionnaire responses. All information is confidential and treated in accordance with applicable provincial and federal privacy legislation.
Are you taking medications of any kind? Include prescription drugs over-the -counter medications (e.g. cold and flu remedy), and natural healthproducts (e.g. vitamins, herbal, and diet supplements). If yes, please list: